“Awareness and Knowledge of Attention Deficit Hyperactivity Disorders among School Counselors and Primary School Teachers in the United Arab Emirates”

CONSENT FORM

Study Principal investigator :

Name : Dr. Mohammed Bardi

Contact details :

Al Amal Hospital

Mobile 0547000992

Email Mohammed.Bardi@moh.gov.ae

Dear participant,

If you are willing to take part in the study, we would request you to please sign and return the following form:

STATEMENTS OF UNDERSTANDING/CONSENT

I confirm that I have read and understand the participant information leaflet for this study.

I have had the opportunity to ask questions if necessary and have had these answered satisfactorily.

I understand that my participation is voluntary and that I am free to withdraw at any time without giving any reason. If I withdraw my data will be removed from the study and will be destroyed.

I understand that my personal data will be processed for the purposes detailed above, in accordance with the Data Protection Act 1998.

Based upon the above, I agree to take part in this study.

Participant : Name, signature and date

Name of participant……(participant's electronic credentials are used as the tool is electonically filled in) ………………… Date…………… Signature………………..

Individual obtaining consent ………m-survey……... Date……April 2019……… Signature……m-survey…https://msurvey.government.ae/modifySurvey/3995/en

For any queries / complaints, please contact ;

Research Ethics Committee Coordinator :

Tel : 04 7078538

Email : yusra.suwaidat@moh.gov.ae

Version 2 / 18-12-2018

This study is part of a project that aims at creating innovative solutions in managing children with symptoms of Attention Deficit and Hyperactivity Disorder (ADHD). The collated data will inform policy makers, regulators, and clinicians to make informed decisions based on empirical findings. Schools are our top partners in this endeavor and we look forward to establishing a collaboration platform that will help little ones to positively challenge their own life limitations. You do not really need to read any references to answer the questions, just provide the choice you think is the most appropriate. This scale is adapted from KADDS, Sciutto et al., 2000.